Association of thrombotic thrombocytopenic purpura and human immunodeficiency virus infection.
A 35 year-old HIV-positive male intravenous drug abuser developed thrombotic thrombocytopenic purpura (TTP) during the course of recto-sigmoiditis secondary to Shigella flexneri. Complete remission was achieved by aggressive treatment of a combination of plasma exchange, fresh frozen plasma infusion, continuous prostacyclin perfusion, p.o. administered aspirin-dipyridamol and intravenous injections of vincristine. During acute microangiopathy, an acquired type II von Willebrand disease was diagnosed. TTP is a newly-recognized hematologic manifestation of HIV-1 infection; endothelial damage by endotoxin during course of infection or by high serum levels of circulating immune complexes may be a causative mechanism of microangiopathy causing hemolysis and platelet consumption.
Beris
P
P
Département de Médecine, Hôpital Cantonal Universitaire, Genève, Suisse.
Dunand
V
V
Isoz
C
C
Reynard
C
C
D000328:Adult; D002939:Ciprofloxacin / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D011350:Proctocolitis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications*; D012763:Shigella flexneri / Q000302:isolation & purification; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014841:von Willebrand Factor / Q000378:metabolism
D014841:von Willebrand Factor; D002939:Ciprofloxacin